Unicompartmental Knee Arthroplasty: A Prospective Analysis and Short-term Results / 대한정형외과학회잡지

PURPOSE: To evaluate the early postoperative results of Unicompartmental Knee Arthroplasty (UKA) based on a prospective analysis and follow up study. MATERIALS AND METHODS: Clinical assessments were carried out using the Knee Society Score (KSS) rating system. The tibiofemoral angle and radiographic changes were measured using weight-bearing X-rays. Prospective assessments were conducted preoperatively, and regularly followed up after the operation. Among the cases of UKA performed since January 2002, 67 were able to be followed up at 3, 6, 12 and 24 months after the operation. RESULTS: For these 67 knees, the average preoperative knee score and the knee function score were 54.6 and 56.3 points, respectively. The knee score was improved to 80.1, 85.4, 86.8 and 89.2 points at 3, 6, 12 and 24 months follow ups, respectively. The knee function score was also improved to 70.4, 76.0, 80.2 and 83.0 points at 3, 6, 12 and 24 months. The average range of knee motion was 127.6 degrees preoperatively, and recovered to 128.6 degrees at 3 months postoperatively. The preoperative tibiofemoral angle was 0.7 degrees of valgus, which changed to 5.7 degrees of valgus at 24 months postoperatively. CONCLUSION: As shown in this prospective study, the early postoperative results of UKA were satisfactory for improvement of knee score, function score and in the recovery of knee motion.

Neurologically Symptomatic Epidural Hematoma after Lumbar Spine Surgery: Comparative Study for Risk Factors / 대한척추외과학회지

STUDY DESIGN: Retrospective and controlled study OBJECTIVES: To verify the risk factors, distinction of symptomatic and prognosis of the postoperative neurologically symptomatic epidural hematoma at the lumbar region. SUMMERY OF LITERATURE REVIEW: Even though an epidural hematoma is one of the well known causes of postoperative neuro-logical complications, the rarity makes it difficult to account for the causes of this phenomenon. MATERIAL AND METHODS: Eight patients who had a proven neurologically symptomatic epidural hematoma were reviewed. We analyzed the degrees of neurologic recovery according to the initial degree of the neurological deficit and the time to the hematoma evacuation. Two hundred four patients who underwent a lumbar operation during the months contemporary with the occurrence of each cases (ed note: I do not know what this means.) by the same surgeon, were selected as the control group. RESULTS: Among the 2,951 patients, 8 patients (0.027%) developed such complication. Using a simple logistic regression test, an increased amount of bleeding, a prolonged operation time, a decreased platelet count before and after surgery, hypertension and previous cardiovascular disease were recognized as significant risk factors, but the statistical significance was lost in all factors by multiple logistic regression test. There was no significant correlation between the neurological recovery and initial neurolog-ical deficit or retardation before the hematoma evacuation. CONCLUSIONS: Compressive epidural hematoma following lumbar spine surgery can cause serious neurological symptom. Significant risk factors were not demonstrated. Therefore, it can be developed in ordinary patients. All cases developed neurological symptom within the first 8 hours after surgery. Accordingly, cautious observation of the neurological changes at early period is important for detecting and treating such complication. The neurologically symptomatic epidural hematoma should be evacuated even in delayed cases, because neurological recovery can be expected.

A 6-year Observation of Multiple Spinal Schwannomas Before Excision: 1 Case Report / 대한척추외과학회지

Spinal schwannoma is a slow growing symptomatic tumor which is derived from Schwann cells of peripheral nerves. Most reported cases have been single lesion, while multiple schwannomas have invariably documented one manifestation of von Recklinghausen's disease. Nevertheless, we observed a case of independent, multiple, spinal schwannomas for 6 years before excision. We report the growing velocity and progression of neurologic symptoms and neurologic changes before excision and present a literature review.